MEDICARE: TIFF'S TENDER CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	00954	TX

General Provider Information

NPI Number	:	1871770453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIFF'S TENDER CARE, INC

Provider Business Mailing Address
First Line	:	3142 CONFEDERATE SOUTH DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4918
Country	:	US
Telephone Number	:	281-835-8118
Fax Number	:

Provider Business Practice Location Address
First Line	:	3803 CARLSON LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-1604
Country	:	US
Telephone Number	:	713-733-5607
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. PAULINE V SKINNER
Credential	:	NP
Telephone Number	:	281-835-8118

Provider Enumeration Date	:	01/26/2008
Last Update Date	:	01/26/2008

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